Diagnostic accuracy of ultrasound scanning for prenatal microcephaly in the context of Zika Virus infection

Ultrasound diagnostic accuracy of head circumference and occipitofrontal diameter parameters were better at ruling in foetal microcephaly with high diagnostic odds ratio, sensitivity, specificity and positive likelihood ratio.

An accurate prenatal diagnosis of microcephaly is critical for foetal prognosis and decision-making by health providers and families of women suspected or confirmed to have ZIKV infection. A systematic review was performed to assess the diagnostic accuracy of ultrasound measurements of foetal biometric parameters for prenatal diagnosis of microcephaly in the context of Zika virus (ZIKV) infection. Nine studies from the USA, Israel, France and Canada were included in the review. Pooled estimates from two studies showed that at 3, 4 and 5 standard deviations (SDs) <mean, sensitivities were 84%, 68% and 58% for head circumference (HC); 76%, 58% and 58% for occipitofrontal diameter (OFD); and 94%, 85% and 59% for biparietal diameter (BPD). Specificities at 3, 4 and 5 SDs below the mean were 70%, 91% and 97% for HC; 84%, 97% and 97% for OFD; and 16%, 46% and 80% for BPD. There were no included studies of ZIKV-infected pregnant women.

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